Active NPI
Michael A. Jaker, M.D.
- Emergency Medicine Physician
- Newark, NJ
National Provider Identifier
1609968445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 25MA03644400
- Practice address
- 150 Bergen St
Emergency Department
Newark, NJ 07103-2496 - Phone
- (973) 972-7846
- Fax
- (973) 972-2384
- NPI assigned
- Sep 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 25MA03644400 | NJ | Primary |
Addresses
Primary practice location
150 Bergen St
Emergency Department
Newark, NJ 07103-2496
Mailing address
30 Bergen St.
Admc 12 1205
Newark, NJ 07107-3000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4864301 | Medicaid | NJ |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mjaker1602@direct.uhnj.org | Direct | University Hospital |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA03644400 | NJ | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642982400000",
"number": "1609968445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 BERGEN ST.",
"address_2": "ADMC 12 1205",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071073000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 BERGEN ST",
"address_2": "EMERGENCY DEPARTMENT",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071032496",
"telephone_number": "973-972-7846",
"fax_number": "973-972-2384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAKER",
"first_name": "MICHAEL",
"middle_name": "A.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-29",
"last_updated": "2022-01-24",
"certification_date": "2022-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NJ",
"license": "25MA03644400",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4864301",
"state": "NJ"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mjaker1602@direct.uhnj.org",
"affiliation": "Y",
"affiliationName": "University Hospital",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "150 Bergen St",
"city": "Newark",
"state": "NJ",
"country_code": "US",
"postal_code": "071032496",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.